Biomedical subjects
Publications and source records attributed to T Anderson.
The management of several types of shoulder fractures is presented. These infrequently occurring fractures are seen in a sports medicine practice. Basic principles of fracture care apply and are used in their treatment. Other fractures not discussed would be treated similarly.
Serial studies were performed in two patients with cyclic thrombocytopenia to investigate the pathogenesis of this disorder. Mean life span of autologous platelets when platelet levels were declining was subnormal (2.4 and 0.8 days), and megakaryocytes were abundant in the bone marrow during thrombocytopenia. Megakaryocyte colony-stimulating activity could not be detected in the serum of either patient at any point of their cycles. In each patient, total platelet-associated IgG varied inversely with platelet levels. Surface platelet-associated IgG was measured only in patient 2 and was significantly elevated (greater than 1,280 IgG molecules per platelet) at all stages of the cycle, even during thrombocytosis. However, the highest values were observed during thrombocytopenia. Platelet-bindable IgG in plasma declined to normal immediately before platelet levels began to rise. IgG eluted from the platelets of this patient reacted strongly with autologous and homologous platelets in contrast to a "mock eluate" prepared from platelets of a normal subject. The eluate from the patient's platelets reacted strongly with immobilized autologous and homologous glycoprotein IIb/IIIa complex and weakly with GPIb but not with isolated GPIIIa alone. In each patient the decline in platelet levels was significantly delayed following administration of intravenous gamma globulin 0.4 g/kg body weight for five days. These findings suggest that platelet-reactive autoantibodies are of pathogenic significance in some patients with cyclic thrombocytopenia.
A direct quantitative and phenotypic cytofluorographic analysis of TCR-gamma/delta+ lymphocytes as well as an immunohistologic study of their tissue distribution and microanatomy was made possible by the availability of two mAbs (anti-TCR-delta 1 and anti-C gamma M1) specific for framework determinants on human TCR gamma and delta chains, respectively. TCR-gamma/delta+ lymphocytes, ranging between greater than 0.5 and 16% of CD3+ cells, were found in fetal and postnatal thymus, fetal and adult peripheral lymphoid organs, and adult peripheral blood. While TCR-gamma/delta+ lymphocytes comprised a small subpopulation of T cells (mean, approximately 4%) occasionally greater than 10-16% of CD3+ cells expressed TCR-gamma/delta. Virtually all TCR-gamma/delta+ thymocytes/lymphocytes expressed CD7, CD2, and CD5 but were heterogeneous with respect to their expression of CD1, CD4, CD8, CD28, CD11b, CD16, and Leu-7. Human TCR-gamma/delta+ cells populate both organized lymphoid tissues (thymus, tonsil, lymphnode, and spleen) as well as the gut- and skin-associated lymphoid systems at similar frequencies without obvious tropism for epithelial microenvironments. TCR-gamma/delta+ lymphocytes tend to be located within a given organ wherever TCR-alpha/beta+ lymphocytes are found. This study shows that TCR-gamma/delta+ lymphocytes constitute a small but numerically important, phenotypically diverse T cell population distributed throughout the body. These results support the concept that TCR-gamma/delta+ cells comprise a distinct, functionally heterogeneous, mature T cell sublineage that may substantially broaden the T cell repertoire at all immunologically relevant sites.
Several authors have investigated the interaction of noise and aspirin in hearing loss, with conflicting results. We studied the combined effects of noise and high doses of aspirin on hearing in rats. Thirty-eight Sprague-Dawley rats were divided into the following five groups: (1) controls; (2) aspirin only; (3) noise only; (4) 8-day per 200 mg of aspirin per noise; and (5) 12-day per 200 mg of aspirin per noise. Auditory brain-stem-evoked responses were measured in each animal prior to, 24 hours after, and 3 weeks after aspirin and noise exposure. The animals were killed and hair cells were counted in 200-micron segments and expressed graphically. Results showed significant differences in permanent threshold shift and hair cell loss between all noise-exposed animals and non-noise-exposed animals. There was also a significantly greater amount of hair cell loss in group 5 when compared with groups 3 or 4. The 12-day per 200 mg of aspirin per noise regimen (group 5) also proved to be fatal for 6 of 15 of these animals, and caused significant weight loss in the survivors. No weight loss or deaths were noted in any other group.
Ninety-one patients with metastatic colorectal cancer were treated with continuous ambulatory 5-fluorouracil (5FU) infusion 250-300 mg/m2/day through a chronic indwelling central venous catheter. Twenty-six of the 91 patients (29%) had received previous bolus 5FU. Fifty-eight of the 91 patients (64%) had two or more sites of disease, and 74 of 91 patients (81%) had liver metastases. Results were complete remission in 5 of 91 (6%), partial remission in 25 of 91 (27%), stable disease in 33 of 91 (36%), and progressive disease in 28 of 91 (31%), for an overall response rate of 30 of 91 (33%); median duration of response was 7 months. Twenty-six of 65 previously untreated patients (40%) experienced objective response. Median survival from initiation of treatment for all patients was 11 months. Forty-one percent of patients experienced no significant toxicity and were able to continue therapy without treatment interruption. Toxicities necessitating treatment interruption included stomatitis in 35 patients (39%), hand-foot syndrome in 33 patients (36%), and diarrhea in 10 patients (11%). No significant myelosuppression or serious catheter-related complications were encountered. We conclude that continuous systemic venous infusion of 5FU produces a higher response rate than traditional bolus 5FU schedules, with apparent enhancement of survival and easily managed toxicity.
Experimental results of ultrasound of varying frequency (0.8-5.0 MHz) propagating in cold drawn wires of stainless steel and aluminium ranging in diameter from 0.25 to 1.21 mm are in close agreement with theoretical predictions. This agreement is maintained when the coupling medium between the wire and the ultrasound source is a short distance of water. Similar measurements for brass and copper wires are in less close agreement with theory due, probably, to the effect of greater anisotropy.
A flow phantom for the generation of physiological Doppler waveforms is described. The suspension of scattering particles is driven by a gear pump powered by a stepping motor. The speed of the stepping motor is controlled by a BBC microcomputer. The waveform shape is selected from a library of waveforms from disc. Use of the microcomputer allows the waveform shape and mean flow to be easily changed. Sephadex particles suspended in a solution of glycerol were used as artificial blood. Thin walled heat shrink tubing which had been moulded around metal rods was used. Distortions in the waveforms caused by reflections from the end of the tubing were largely removed by reducing the pipe diameter to half of its value for 30 cm from the end of the pipe. There was good agreement between the control waveforms and the Doppler waveforms over a wide range of waveform pulsatility.
5-Fluorouracil (5FU) administered by prolonged intravenous infusion may more effectively treat advanced, slow-growing tumors with low growth fractions and long doubling times. Protracted infusion provides continual cancer cell exposure to 5FU; limitations due to cell cycle specificity and a short plasma half-life are theoretically circumvented. Advances in catheter composition and pump technology now make ambulatory infusion therapy widely available. Clinical trials suggest that prolonged infusion may improve the response rate in colorectal cancer. In addition, preliminary results suggest clinical activity against gastric, pancreatic and refractory breast cancers with minimal toxicity. Despite the potential logistic problems of infusion chemotherapy, many patients report improved quality of life. Increased costs incurred from infusion therapy are probably justifiable if survival is prolonged and quality of life maintained.
Evolution of psychoanalytic dream theory from the topographical-conflict model resulted in the relative ascendance of manifest dream content and structure. Correspondingly, Freud's emphasis on the latent dream, disguised unconscious wish-fulfillment function, was paralleled by the development of an ego problem-solving-conflict function demonstrably observable in subjects' and patients' nocturnal dreams in sleep-lab REM awakenings. This development culminated in clinical, theoretical, and operational adoption of binary opposition as a language of manifest dream structure and a corresponding definition of mental health in terms of personal problem-solving efficacy measured in a narrative as self-defined, self-advocacy-adversary statements of sequences. Process and outcome measures from initial studies of psychoanalytic patients and nonpatients' dreams evidenced concurrent validity. Use of this measure on the three types of dreams reported in Freud's seminal The Interpretation of Dreams yielded results which support the inference that Freud's dreams are significantly more healthy than those of his patients or others (mostly colleagues).
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Two patients developed breast cancer after treatment of Hodgkin's disease. Both had received mediastinal irradiation 13 to 15 years, respectively, before the diagnosis of breast carcinoma. One patient had synchronous bilateral breast cancer when the diagnosis was made. Discussed is the risk of mammary carcinoma as a second malignant neoplasm in patients treated for Hodgkin's disease.
Calcaneus secundarius, a minor anatomical variant in the foot, is subclinical and its true prevalence in modern populations is uncertain. The trait is clearly visible in dry bones, and osteo-archeological evidence suggests that it may be a more frequent occurrence than was formerly thought. The etiology of the trait is outlined, and its possible value is assessing "biological distance" in past populations is considered.
Rhabdomyosarcoma is one of the most common malignancies of the mesenchymal tissue in the head and neck region. A case of a 26-year-old male with oral rhabdomyosarcoma is presented. The clinical and pathologic aspects of this malignancy are also reviewed. Furthermore, the histopathologic and ultrastructural features of this neoplasia are described and the important role of electron microscopy in diagnosis of the myogenic tumor is emphasized. Finally, different modes of treatment for the rhabdomyosarcoma are discussed.
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Fourteen patients with advanced gastric adenocarcinoma were treated with continuous 5-fluorouracil (5-FU) infusion, 300 mg/m2/day, through an indwelling central venous catheter; 13 were evaluable for response. The results were as follows; Partial remission was seen in 4 of 13 patients (31%), stable disease in 5 of 13 patients (38%), and progressive disease in 4 of 13 patients (31%). The median duration of response was 19 weeks (range, 10-41), and the median survival for all patients from initiation of infusion was 27 weeks (range, 9-54). Treatment interruption and/or dosage attenuation for toxicity was necessary in 7 of 14 patients (50%); however, myelosuppression, alopecia, and nausea and vomiting were not observed. 5-FU infusion is well-tolerated, palliative therapy for patients with advanced gastric carcinoma and may warrant further investigation in combination with other chemotherapeutic drugs.
UNLABELLED: Sixteen patients with metastatic carcinoma of the pancreas were treated with continuous ambulatory 5-Fluorouracil (5FU) infusion (200-300 mg/m2/day) through a chronic indwelling central venous catheter. Twelve of sixteen patients (75%) had two or more sites of disease, and eleven of sixteen (69%) had liver metastases. Five patients had previous chemotherapy. RESULTS: partial remission, 3/16 (19%); stable disease, 8/16 (50%); and progressive disease, 5/16 (31%). Improvement in ECOG performance status was observed in 2/3 responding and 6/8 stable disease patients, respectively. Toxicities included hand-foot syndrome, mucositis, diarrhea, and cerebellar ataxia, which required treatment interruption in 9/16 patients (56%). No myelosuppression or catheter related problems were seen. The authors conclude that continuous infusion 5FU is a potentially efficacious palliative therapy in the management of carcinoma of the pancreas.
Preoperative laser photoresection of a bronchial adenoma allowed more accurate evaluation and better planning of the operative procedure.